Category: PLACENTA PREVIA

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Painless – sometimes massive – bleeding in the last trimester of the pregnancy strongly suggests previa.

Same treatment whether fetus is alive or dead:

• Immediate resuscitation with fluids
• Transfuse one or two units of fresh blood
• Perform ultrasound examination
  • Total previa:
    • C/S
  • Marginal previa:  
    • Rupture the bulging membranes
      • Diminishes traction on the placenta
      • Reduces bleeding
    • Deliver vaginally

When ultrasound is not available

• Bring patient directly to the operating theater
• Prepare for urgent C/S
• Perform gentle speculum examination
  • Total previa:
    • C/S
  • Marginal previa:
    • Rupture the bulging membranes
      • Diminishes traction on the placenta
      • Reduces bleeding
    • Deliver vaginally

Watch out for signs of DIC (HELLP Syndrome). Transfuse with fresh blood at the slightest suspicion